Individual
STEPHANIE N GILLERAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
285 SILLS RD, BUILDING 7, SUITE B, EAST PATCHOGUE, NY 11772-4869
(631) 654-4577
(631) 654-3391
Mailing address
285 SILLS RD, BUILDING 7, SUITE B, EAST PATCHOGUE, NY 11772-4869
(631) 654-4577
(631) 654-3391
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
221807
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02556187
—
NY
Enumeration date
09/20/2005
Last updated
08/16/2007
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